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Treatment Patterns for Early Pregnancy Failure in Michigan

dc.contributor.authorDalton, Vanessa K.en_US
dc.contributor.authorHarris, Lisa H.en_US
dc.contributor.authorClark, Sarah J.en_US
dc.contributor.authorCohn, Lisa M.en_US
dc.contributor.authorGuire, Kenen_US
dc.contributor.authorFendrick, A. Marken_US
dc.date.accessioned2010-10-14T14:20:47Z
dc.date.available2010-10-14T14:20:47Z
dc.date.issued2009-06en_US
dc.identifier.citationDalton, Vanessa K.; Harris, Lisa H.; Clark, Sarah J.; Cohn, Lisa; Guire, Ken; Fendrick, A. Mark (2009/05/17). "Treatment Patterns for Early Pregnancy Failure in Michigan." Journal of Women's Health, 18(6): 787-793 <http://hdl.handle.net/2027.42/78155>en_US
dc.identifier.issn1540-9996en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/78155
dc.description.abstractAbstract Aims: We describe current treatment patterns for early pregnancy failure (EPF) among women enrolled in two Michigan health plans. Methods: We conducted a retrospective review of EPF treatment among Michigan Medicaid enrollees between January 1, 2001, and December 31, 2004, and enrollees of a university-affiliated health plan between January 1, 2001, and December 31, 2005. Episodes were identified by the presence of a diagnostic code for EPF. Surgical treatment was distinguished from nonsurgical management using procedure codes. Facility charges, procedure, and place of service codes were used to determine whether a procedure was done in an office as opposed to an operating room. Cases without a claim for surgical uterine evacuation were examined for a misoprostol pharmacy claim and, if present, were classified as medical management. Cases without a procedure or pharmacy claim were classified as expectant management. Results: Respectively, we identified 21,311 and 1,493 episodes of EPF in the Medicaid and university-affiliated health plan databases, respectively. Women enrolled in Medicaid were more likely to be treated with surgery than were enrollees of the university-affiliated health plan (35.3 vs. 18.0%, respectively, p<0.000). Among Medicaid enrollees, only 0.5% of surgical evacuations occurred in the office, but office procedures were common among enrollees of the university-affiliated health plan (30.5%, p<0.000). The proportion of cases managed with misoprostol was <1% in both groups. Caucasian race and age were both associated with having a surgical uterine evacuation (p<0.001). Conclusions: EPF is primarily being treated with expectant management or surgical evacuation in an operating room and may not reflect evidence-based practices or patient preferences.en_US
dc.format.extent166725 bytes
dc.format.extent3100 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypetext/plain
dc.publisherMary Ann Liebert, Inc.en_US
dc.titleTreatment Patterns for Early Pregnancy Failure in Michiganen_US
dc.typeArticleen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.identifier.pmid19445643en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78155/1/jwh.2008.1091.pdf
dc.identifier.doi10.1089/jwh.2008.1091en_US
dc.identifier.sourceJournal of Women's Healthen_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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